I've no idea who Avital Schurr is. But he appears to be an anaesthetist, always a plus point, and he has a view of glycolysis which I really like.

I've blogged before on the astrocyte-neuron lactate shuttle and why I, from my own personal viewpoint, consider lactate to be the ideal mitochondrial fuel when reverse electron transport through complex I is best avoided. It behaves like glucose but without easy access to mtG3Pdh. With the exclusion of fatty acids from neurons the only reduction in the CoQ couple other than complex I then comes from complex II, part of the TCA. There is no input from ETFdh or mtG3Pdh. Pure acetyl-CoA, driving mostly through complex I.

The lactate shuttle is controversial.

Many years ago I recall a sketch on a comedy program, probably on Radio 4, where two politicians of irreconcilable views were invited in to the studio to debate the finer points of some policy by throwing half-bricks at each other.

I never really realised this at the time but the lactate shuttle polarises people. Lactate is viewed by many as an utterly useless, rather toxic end product of anaerobic glycolysis. It is a surrogate for hypoxia, hypoperfusion or mitochondrial failure. It is remarkably unacceptable to almost all physiologists that lactate can be a super fuel or even a fuel of any sort at all. Schurr goes through the arguments and the people and the papers and the logical fallacies and how two groups can look at the same data and draw radically differing conclusions. Think LCer vs vegan vs potato head. You look at the same studies but see different explanations......... And you know, we can't all be correct. Lactophobia is an emotional response. Schurr's words are ‘glucoseniks’ vs ‘lactatians’. You really have to read the paper!

Obviously, when you run out of NAD+ glycolysis would grind to a halt. But just look at how neat things become if you take glycolysis through to lactate:

Glycolysis, if it runs to lactate, is self sustaining. There is no deficit of NAD+, just an NAD+:NADH cycle. There is no need for the glycerol-3-phosphate shuttle, not for NAD+ regeneration anyway. Obviously, once lactate enters the mitochondrion it gets converted back to pyruvate with the generation of NADH. But this NADH is where it's needed, in the mitochondrial matrix, well away from the nucleus, ready to be processed by complex I.

How neat is that? Edward Edmonds suggested "elegant" as the descriptor. Yes, some hypotheses are so elegant the really have to be correct.

If it is correct you can then start asking questions about what mtG3Pdh is doing (if it's not regenerating NAD+) and how this might fit in with metformin. We're also back to what controls insulin sensitivity and how a cell regulates energy throughput. And fructose. And hyperglycaemia. Lots to think about.

About Me

I am Petro Dobromylskyj, always known as Peter. I'm a vet, trained at the RVC, London University. I was fortunate enough to intercalate a BSc degree in physiology in to my veterinary degree. I was even more fortunate to study under Patrick Wall at UCH, who set me on course to become a veterinary anaesthetist, mostly working on acute pain control. That led to the Certificate then Diploma in Veterinary Anaesthesia and enough publications to allow me to enter the European College of Veterinary Anaesthesia and Analgesia as a de facto founding member. Anaesthesia teaches you a lot. Basic science is combined with the occasional need to act rapidly. Wrong decisions can reward you with catastrophe in seconds. Thinking is mandatory.
I stumbled on to nutrition completely by accident. Once you have been taught to think, it's hard to stop. I think about lots of things. These are some of them.

Organisation (or lack of it)!

The "labels" function on this blog has been used to function as an index and I've tended to group similar subjects together by using labels starting with identical text. If they're numbered within a similar label, start with (1). The archive is predominantly to show the posts I've put up in the last month, if people want to keep track of recent goings on. I might change it to the previous week if I ever get to time to put up enough posts in a week to justify it. That seems to be the best I can do within the limits of this blogging software!